Birmingham Surgeons created endoscope-i an award-winning system that enables the viewing, recording & sharing of HD endoscopic images & videos using an iPhone/iPod. Endoscope-i works with existing endoscopes or supplied as a secured turn-key solution

Originally developed as a simple and cost effective solution to mobile endoscopic HD imaging Endoscope-i can benefit both clinicians and patients across several specialities. To date otolaryngologists, urologists, gynaecologists, orthopaedic physicians, laparoscopic surgeons and anaesthetists are some of the many specialties which benefit from using endoscopes. The superior lighting and optics allow for visualisation of 'hard to reach' areas within the human body. Endoscope-i has been involved in a number of projects globally to facilitate cost effective HD imaging and documentation.

The multiple award winning Endoscope-i is simple to operate and comprises an adapter to connect a medical endoscope to align with the camera of an iOS device (iPhone or iPod). The ‘e-iPro’ app allows the user to calibrate and centre the acquired image and prevents rotation allowing images to be recorded in high definition (HD) video or still images which can be shown to the patients and stored in the patient’s medical record in seconds.

Endoscope-i will fit any endoscope with a 32mm eyepiece, which means the possibilities are endless. A shared endoscopic view was previously the reserve of the privileged few - where they have large expensive stacking systems - Endoscope-i makes this technology available to everyone, at a fraction of the cost and in a more convenient portable format.” People are surprised to hear that before Endoscope-i, clinicians relied on hand drawn sketches to update patient records.

NB: Data and images are currently distributed via NHS.net. Discussions are ongoing with the Information Commissioners Office to design bespoke data management protocols.

Endoscope-i is available to fit a range of iOS devices and has a multitude of uses which include both clinical and non clinical applications such as:-

Otolaryngology HD imaging of the ear nose & throat to allow rapid and easy storage and sharing of images and videos with both patients and clinicians

Anaesthetics Portable HD viewing to facilitate endoscopic fibre optic intubations available at any time

Veterinary Small and large animal endoscopy from the surgery to the field using the most advanced portable camera technology

Engineering Carry only one portable device for communication and sharing of images obtained on site

Stage of Development:

Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)

Benefit to NHS:

A target has been set for the NHS to become paperless by 2020. Many health trusts have facilitated this by creating their own electronic health record (EHR). However, though a transcription of the patient consultation can be typed directly into the record there is no efficient means of capturing and storing images of patient findings safely into the patient record.

The speciality of ear, nose and throat (ENT) examines areas of the body that are usually difficult to visualise without endoscopes. However even though there it is possible to see inside the ear nose and throat many doctors must then create a sketch of their observations for documentation.

To overcome this major problem, a mobile imaging solution - Endoscope-i - has been developed by a team of specialists which include engineers, software developers and practicing clinicians. The ‘Endoscope-i system’ uses the power of smart phones to quickly and safely capture images from endoscopes and store them directly into the patients EHR with the touch of a button. What’s more, patients can now share their own examination findings with their doctor or relatives to understand their condition better.

The images produced are of such high definition that they can be taken by doctors in primary care and then sent on to specialists in secondary care for an expert opinion, without the patient ever having to go to hospital. This saves the cost of an outpatient referral for the commissioning group, is far more convenient for the patient, reduces unnecessary journeys, frees Consultants’ clinic time, speeds diagnosis and in the long term could save millions of pounds for the NHS.

Benefit to WM population:

The proposed ‘Telescopic Mobile referral service’ will allow patients to get expert opinions of their ear conditions within hours and without ever having to visit the hospital, thus saving valuable consultant time and minimising travel and inconvenience for the patient.

Reduced cost and greater access to services will result through the use of Endoscope-i as there is no longer a need for multiple data capture and processing devices as each Consultant can use their own iOS device to record and transfer images. Additionally, Endoscope-i will work with existing endoscopes that have a 32mm diameter eyepiece and so directly enhances the equipment’s clinical benefit.

In the three months of the Telescopic Referrals (Telemedicine using Endoscope-i) in North Staffordshire and Stoke and Trent, 27 referrals have been dealt with remotely from 6 GP practices. 24 of these cases were managed without referral giving an 88% success rate to referral.

In the West Midlands region, a new patient referral currently costs the CCG £107 compared to the remote ‘Telescopic’ referral cost of £30, a dramatic saving for the CCG. This has already saved £1,758 in referral costs alone without measuring the indirect cost benefits for patients who did not require the Telescopic referral because of the improved diagnostic ability the GP had when using Endoscope-i.

Reducing the need for a physical consultation will also result in transport savings and time ‘away from work’ costs for both the patient and any employer.

Current and planned activity:

Current WMHASN funded project with Dr Ruth Chambers (Clinical Telehealth Lead at NHS Stoke-on-Trent Clinical Commissioning Group), using 15 practices from the S-O-T and North Staffordshire CCGs piloting the Telescopic Mobile Referral Service. Currently 3 months into preliminary data collection showing 30 referrals handled with Telescopic referrals powered by Endoscope-I technology. Almost 90% of patients referred avoid being sent to hospital. Cost of teleconsultation is only £30 compared to £107 for a new patient hospital consultation.

Endoscope-i not only provides a rapid consultant opinion for the patient but helps to deal with the excessive burden on secondary care services by keeping chronic disease and some acute ear disease management within primary care.

What is the intellectual property status of your innovation?:

No patent on product. We have full copyright of the code written for the app. Endoscope-i is a registered trademark and adapter designs fall under design copyright.

Return on Investment (£ Value):

Very high

Return on Investment (Timescale):

1 year

Ease of scalability:

Simple

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Hi Neil
With regards to IG we are using the IG toolkit through NHS Digital which is currently undergoing a revamp. All our governance measures still follow this and all the required risk assessments. We are currently awaiting our ODS number to apply for access through to the N3 once all the governance paperwork has been checked, it would be nice to go through this with you. Ideally we would like to use a cloud based service apprpriate to ICO recommendations when all the governance checks are cleared. It appears that N3 are advertising this and taking details of interested parties. In the meantime we are actually working with the NHS.net team via accenture as this is the only safe way of transfering any OFFICAL SENSITIVE data netween nhs.net accounts. e-i are looking to obtain their own nhs.net accounts. The accenture team and e-i are working with each others APIs to create a fully automated safe system to store and transfer data.

The porposed pathway is the one currently being used as a service evaluation in two of the 6 CCGs in the Staffordshire STP footprint, This is that the GP uses our technology to examine, record and send any queries to myself or Chris in e-i. We respond with an answer. Provisional datat shows 90% of referrals to e-i avoid a hospital attendance.

In terms of a business model we see this being sold as a package to the GPs. There is more to the technology and its worth seeing in person. The e-i kit is capable of so much more without any further capital investment. Would love to show this to you sometime.